双侧中央区淋巴结清扫术在分化型甲状腺癌手术治疗中的应用
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摘要
目的:探究分化型甲状腺癌手术治疗中应用双侧中央淋巴结清扫术的临床效果。方法:选取42例分化型甲状腺癌手术患者,根据治疗方法的不同将其分为观察组与对照组两组,对照组患者采用甲状腺切除术与双侧中央区颈淋巴结清扫手术联合治疗,观察组患者采用保留对侧喉返神经入喉之处甲状腺组织的甲状腺次全切除手术与双侧改良颈淋巴结清扫手术联合治疗。对比两组患者的生存周期、复发率、生化治愈率、并发症发生率以及生存质量评分。结果:对照组患者生存周期(92.26±12.45)个月,观察组患者生存周期(99.26±20.85)个月,两组患者生存周期的对比,差异无统计学意义(P>0.05);对照组患者复发率以及并发症发生率分别为60%、50%,均高于观察组的27.27%、4.55%,差异有统计学意义(P<0.05);对照组患者的生化治愈率15%,低于观察组的45.45%,差异有统计学意义(P<0.05);两组患者临床症状、心理状态、日常生活、社会活动、生理函数状态以及总生存质量评分的对比,差异无统计学意义(P>0.05)。结论:保留对侧喉返神经入喉之处甲状腺组织的甲状腺次全切除手术与双侧改良颈淋巴结清扫手术联合治疗分化型甲状腺癌的复发率、并发症发生率、生化治愈率优于甲状腺切除术与双侧中央区颈淋巴结清扫手术联合治疗。
Objective To explore the clinical effect of bilateral central lymph node dissection in surgical treatment of differentiated thyroid carcinoma.Method 42 patients with differentiated thyroid cancer treated in our hospital were divided into two groups according to the different treatment methods.The patients in group A were treated with thyroidectomy combined with bilateral central neck lymph node dissection,while those in group B were treated with thyroid reserving the place where the contralateral recurrent laryngeal nerve entered the larynx.Tissue subtotal thyroidectomy combined with bilateral modified cervical lymphadenectomy.The survival cycle,recurrence rate,biochemical cure rate,complication rate and quality of life score of the two groups were compared.Results The survival period of group A was(92.26±12.45) months,that of group B was(99.26±20.85) months,and that of two groups was compared(P>0.05).The recurrence rate and complication rate of group A were 60% and 50%,respectively,which were higher than those of group B,27.27% and 4.55%(P<0.05).the comparison of clinical symptoms,psychological status,daily life,social activities,physiological function status and total quality of life score between the two groups(P>0.05).Conclusion The recurrence rate,complication rate and biochemical cure rate of differentiated thyroid cancer treated by subtotal thyroidectomy and bilateral modified cervical lymph node dissection with preservation of the contralateral recurrent laryngeal nerve entering the larynx were better than that of thyroidectomy and bilateral central cervical lymph node dissection.
Objective To explore the clinical effect of bilateral central lymph node dissection in surgical treatment of differentiated thyroid carcinoma.Method 42 patients with differentiated thyroid cancer treated in our hospital were divided into two groups according to the different treatment methods.The patients in group A were treated with thyroidectomy combined with bilateral central neck lymph node dissection,while those in group B were treated with thyroid reserving the place where the contralateral recurrent laryngeal nerve entered the larynx.Tissue subtotal thyroidectomy combined with bilateral modified cervical lymphadenectomy.The survival cycle,recurrence rate,biochemical cure rate,complication rate and quality of life score of the two groups were compared.Results The survival period of group A was(92.26±12.45) months,that of group B was(99.26±20.85) months,and that of two groups was compared(P>0.05).The recurrence rate and complication rate of group A were 60% and 50%,respectively,which were higher than those of group B,27.27% and 4.55%(P<0.05).the comparison of clinical symptoms,psychological status,daily life,social activities,physiological function status and total quality of life score between the two groups(P>0.05).Conclusion The recurrence rate,complication rate and biochemical cure rate of differentiated thyroid cancer treated by subtotal thyroidectomy and bilateral modified cervical lymph node dissection with preservation of the contralateral recurrent laryngeal nerve entering the larynx were better than that of thyroidectomy and bilateral central cervical lymph node dissection.
引文
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[4] 吕春晖,陈海珍,沈晓卉,等.纳米碳在双甲全切加双侧中央区淋巴结清扫术中的临床应用[J].中华内分泌外科杂志,2017,11(1):34.
[2] 张红梅,尹乐平.双侧中央区淋巴结清扫术在分化型甲状腺癌手术治疗中的应用[J].实用医院临床杂志,2015,12(3):157.
[3] 陈岚.腔镜下治疗早期分化型甲状腺癌可行性及临床应用价值分析[J].吉林医学,2017,38(5):843.
[4] 吕春晖,陈海珍,沈晓卉,等.纳米碳在双甲全切加双侧中央区淋巴结清扫术中的临床应用[J].中华内分泌外科杂志,2017,11(1):34.